Job Overview
Location
Massachusetts WFH
Job Type
Full-time
Category
Software Engineering
Date Posted
June 25, 2026
Full Job Description
đź“‹ Description
- • Serves as the primary point of contact for new members transitioning to CCA/CareSource health plans, conducting telephonic outreach and providing inbound call support until their care team is established
- • Identifies and verifies members’ existing healthcare services and documents new service requests through analysis of claims, referrals, and pharmacy data
- • Educates new members on CCA/CareSource health plan offerings, answering questions and addressing concerns to ensure understanding and engagement
- • Contacts hard-to-reach members using internal and external resources to obtain accurate contact information and establish communication
- • Coordinates with internal CCA/CareSource providers and external healthcare providers to ensure continuity of care during member transition
- • Schedules initial nurse intake visits for new members to facilitate timely clinical onboarding
- • Applies motivational interviewing techniques to build trust, encourage participation, and engage members who are hesitant or disengaged
- • Utilizes telehealth technologies (video, chat) to deliver clinically appropriate care management and clinical care services when needed
- • Maintains comprehensive, professional documentation of member interactions, needs, and service requests in electronic systems
- • Collaborates with internal stakeholders and external healthcare organizations to align care delivery and resolve member issues
- • Demonstrates cultural sensitivity and effective communication skills when interacting with members from diverse backgrounds
- • Applies knowledge of community resources and healthcare systems to identify unmet needs and escalate appropriately
- • Uses electronic medical record and care management systems to query data, track member progress, and support care coordination
- • Maintains strong interpersonal skills including active listening, dependability, and responsiveness while establishing clear boundaries and expectations
- • Manages multiple tasks in a fast-paced environment with competing priorities while ensuring accuracy and completeness of work
- • Demonstrates proficiency in Microsoft Office applications including Outlook, Calendar, and Word
- • Willingness to learn and adopt new telehealth platforms and clinical care technologies as required
🎯 Requirements
- • Bachelor’s Degree or relevant experience in a call center and/or Medicare/Medicaid plan environment
- • Five (5) years of relevant work experience
- • One (1) year of experience in outreach or community work with individuals facing behavioral, medical, social, or interpersonal complexities
- • Experience working in a multi-cultural setting
- • Experience using motivational interviewing techniques in a professional context
- • Experience identifying unmet healthcare needs and escalating them to appropriate parties
🏖️ Benefits
- • Compensation range of $47,400.00 - $76,000.00 hourly
- • Eligibility for a bonus tied to company and individual performance
- • Comprehensive total rewards package focused on employee well-being
- • Opportunity to work remotely from Massachusetts
Skills & Technologies
See exactly how your profile matches this role — strengths, skill gaps, and what to do about them.
About CareSource Management Group Company
CareSource is a nonprofit, multi-state managed care organization headquartered in Dayton, Ohio. Founded in 1989, it administers Medicaid, Medicare Advantage, and Marketplace health plans serving over two million members in Ohio, Kentucky, Indiana, West Virginia, and Georgia. The company focuses on improving health outcomes for low-income and vulnerable populations through integrated care management, behavioral health services, and social determinants programs.
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